Strategic Estates Plan
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Pan Staffordshire Health Economy Strategic Estates Plan DRAFT & CONFIDENTIAL: FOR DISCUSSION PURPOSES ONLY June 2016 Document status In respect of any request for disclosure under the FoIA: This is a confidential document for discussion purposes and any application for disclosure under the Freedom of Information Act 2000 should be considered against the potential exemptions contained in s.22 (Information intended for future publication), s.36 (Prejudice to effective conduct of public affairs) and s.43 (Commercial Interests). Prior to any disclosure under the FoIA the parties should discuss the potential impact of releasing such information as is requested. The options set out in the SEP are for discussion purposes. The involved NHS bodies understand and will comply with their statutory obligations when seeking to make decisions over estate strategies which impact on the provision of care to patients and the public. The options set out do not represent a commitment to any particular course of action on the part of the organisations involved. Contents 1. Executive Summary 2. Introduction and Objectives 3. Methodology 4. Key Drivers and Challenges 5. The Current Estate 6. Vision for the Estate 7. Gap Analysis and Priorities 8. Summary of Opportunities 9. Outline Benefits Summary 10. Implementation and Next Steps 11. Appendices Executive Summary Where we are now? Where do we want to be? How do we get there? The SEP is a pragmatic plan that will deliver change. This initial iteration sets out the current situation in Staffordshire. The next iteration of the SEP report will comprise: . Comprehensive review of the ‘as-is’ health estate, including utilisation; . Vison for future estate based on commissioning/service priorities; - List of priority estate projects for further analysis and implementation; - Summary of the likely clinical and financial benefits identified; - Summary of specific next steps; - Outline implementation programme. Executive Summary • The Interim SEP, produced in December 2015, was a high level snap shot of Staffordshire at that time and focused mainly on primary care • The LEF had only just been established and any estate work was in its early stages, linking as a workstream of the Pan Staffordshire Transformation Programme • The Staffordshire health economy is committed to using the estate as an enabler to deliver long term savings, efficiencies and to support the introduction of new models of working • Through this commitment, the health economy, together with the rest of the public sector, is working together to deliver a shared vision for the future of Staffordshire • A lot of work has been carried out in the intervening 6 months and the future commitment, linked through the STP, is strong Executive Summary • Staffordshire is a big county, historically split between North and South, as to how it is managed, in terms of health, and public, services • Following on from the Mid Staffs issues, Staffordshire is now viewed by the NHS as a whole and the Pan Staffs Transformation Programme was set up to ensure this, bringing together the 6 CCGs • Estates is a workstream of the Pan Staffs Transformation Programme, led by NHS England • Primary care in the area is led by NHS England, with the CCGs encouraged to have a greater involvement • The first LEF in Staffordshire took place on 14 October 2015 following on from CHPs initial contact with Staffordshire in August • Current focus is on greater efficiency within the primary care estate • There are numerous exciting opportunities across the health economy to deliver services in a different way, providing both efficiency savings and better utilisation of existing properties. STP • The whole Staffordshire health economy makes up the footprint for the STP • It is led by John MacDonald, Chair of the University Hospitals of North Midlands • The full details of the STP are currently being discussed but it is anticipated that estates will be an associated workstream in the process, supporting the further integration of the new models of working, which is anticipated to see more local services being provided closer to home, instead of in hospital facilities Introduction and Objectives The Pan Staffordshire Strategic Estates Plan (SEP) begins with a review of the healthcare estate so as to inform an emerging new strategic direction for the local health economy. The SEP is the initiative of the Staffordshire Local Estates Forum (LEF) which is comprised of the county’s Clinical Commissioning Groups (CCGs) working in partnership. It will inform a national, centrally-funded strategic healthcare estates development programme. This document is a “snapshot” of available information, including data that has been modelled to extrapolate the big picture and initial headline findings. It is a product of the ongoing process of collaborative development of the SEP involving the key stakeholders in the commissioning and provision of healthcare for the Pan Staffordshire health economy. The objectives of this document are as follows. To identify indicative gaps in understanding and information. To provide the data modelling that will enable alignment of commissioning service requirements and estates requirements in the next iteration. To identify opportunities to improve the estate (eg utilisation and rationalisation) that could deliver benefits including clinical and financial. To inform a system-wide view that is integrated with the principles of the One Public Estate Programme. Methodology: the SEP Development Process Step 3 The Estate that You Need (Vision) Service Needs Step 4 Step 6 Vision for Technology Gap The SEP the Estate Analysis Population Changes Step 1 Gap Options Analysis Analysis SEP Getting Prepared Estate Condition Step 5 Estate Options Capacity Estate Use Identification & Testing Step 2 The Current Estate Stage 4 Strategic Stage 3 Implementation Gap Analysis Plan Stage 2 and Option Strategic Fit Appraisal Stage 1 Analysis Data Collection and Mapping Process Methodology – an integrated approach The development of the SEP necessitates an integrated approach involving extensive consultation with a variety of stakeholders including the following. • Local Authority Forward Planning teams • County Council Infrastructure teams • Healthcare Provider estates leads – Acute, Community, Primary Care, Mental Health, • Healthcare Commissioners Research undertaken includes the following key sources. • Local Authority Core Plans, Demographic Projections, Provider Strategic Plans • Major Housing & Economic Developments • Monthly Strategic Estates Group meetings • Strategic Healthcare Asset Planning and Evaluation (SHAPE) toolkit Methodology: SEP developed by LEF chaired by CCGs H&WBBs and system leadership groups One Public Estate Programme Provider Trusts CCG NHSPS/CHP NHSE Local Estate Forum LIFTCo Local Authorities Strategic Estate Adviser (from either CHP or NHSPS) Key Drivers and Challenges Drivers for Change Estates Impact Population growth • Additional GP practices incorporated within community health facilities wherever possible. • Integration of GP and community care at scale, provided through multi-specialty centres. The financial challenge across the health • Estate savings and efficiencies needed to assist economy: must be addressed, but the quality reduction in spend on infrastructure. of service must also be maintained • Modern, purpose-built premises with bookable spaces for use by many providers will ensure quality of provision. Need to drive efficiencies via closer work • Integrated, multi-specialty healthcare centres with provider organisations provide potential solution, including greater efficiencies in administrative services. Pockets of multiple deprivation, with high • Use of the estate for preventative measures can levels of high-risk behaviours and multiple be achieved through reconfiguration. conditions • Multi-speciality centres needed for frail elderly and those with Long Term Conditions/complex needs. Key Drivers for Commissioners and Providers Enhancing the patient journey with an improved quality estate, greater access to primary care and integrated community based services Integration with local authority services is increasingly important and urgent The NHS needs to identify significant revenue savings that cannot be found through efficiencies alone, but through whole system and service redesign with a specific focus on integrated health and social care, greater levels of care within communities and new commissioning models A sustainable funding solution for estate improvements is required Significant revenue cost and capital may be tied up in underutilised and inefficient estate which is often not in the right location to deliver the necessary services to the local population Implementation of improved methods of clinical delivery through changing care models incorporating technology to provide patient care to a widely dispersed population and reduce costs Key consideration of the One Public Estate and introducing drivers for change through collaborative working with other organisations Overarching driving forces NHS Five Year Forward View One Public Estate NHS England: A Call to Action Better Care Fund Changes in Demography, Population Health and Wellbeing Strategy Growth and Deprivation CCG/Provider Operational plans National policy context relevant to Staffordshire CCGs In October 2014, the NHS published the Five Year Forward View, which detailed new models of care to integrate acute with Out of Hospital (OoH) services. 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